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Home My WebLink AboutX2022-0923 - Permits�aN'r•rx2r City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2022-0923 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 2 0 9 2 3 Project No : 0854-2022 Permit Counter Phone (949)644-3288 .� Inspection Requests Phone (949)644-3255 Issued Date : 06/28I2022 Combination Type - CIP MECH ELEC PLUM Inspection Area : 7 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY OR PERMIT WILL BE INVALID Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. No work on Sundays or Holidays Job Address: 500 SUPERIOR AVE NB St: 1 FI: 1 Unit: 100 Description: COMM TI OF 6870 SF IN (E) MED OFFICE BUILDING FOR OSHPD3 CLINIC Legal Desc.: IRVINE SUB LOT 169 BLK 2 PORS OF LOT Owner: HEALTHCARE NEWPORT Address: 1 HOAG DR NEWPORT BEACH, CA 92663 Phone: 949-764-4464 Applicant: KREUTZER MATTHEW Address: 300 SPECTRUM CENTER DR #730 IRVINE, CA 92618 Phone: 949-727-9000 Code Edit : 2019 Type of Construction: V-A- SPR Occupancy Group: B Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 3 No of Units : 0 Bldg Height: 0 Bldg Sprinklers: Y Flood Zane: X Valuation: Building Permit Fee: $6,372.00 Plan Check Fee: $5,543.64 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $112.00 Energy Compliance: $550.00 CA Seismic Safety : $0.00 Disabled Access : $944.00 Hazardous Mat $0.00 Building Green Fee : $40.00 TOTAL FEE: $18,473.96 Contractor: RENAULT & MORAN CONSTRUC. Address: 19900 MACARTHER BLVD #600 IRVINE CA 92612 Phone: 949-412-6500 Con State Lic: 1038156 Lic Expire: 04/30/2024 Bus Lic: BT30065288 Lic Exp Date: 1213112022 Worker's Compensation Insurance Carrier: NATIONAL FIRE INS CO OF HARTFO Policy No: 7600021597211 Expire: 06/12/2023 Building Setbacks Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: Rear: / Front: I Left: I Right: / Parking Spa $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $1,668.19 $1,310.72 $1,072.41 Architect: HERNANDEZ DARCIA KAY Address: 300 SPECTRUM CENTER DR #370 IRVINE CA 92610 Phone: 714-206-2275 State Lic:C030188 Engineer: Address: Phone: State Lic: Designer: Address: Phone: Special Conditions: WASTE MGMT TO HAUL DEBRIS Fire Planning Department - Plan check Fee Fair Share SJH Trans In -lieu Housing Fee Public Works Department - Park Dedication : $0.00 PM Plan Check : $0.00 San Dist: $0.00 NMUSD Fee: $0.00 Fire De�t1� $52.00 Fire Inspection: $0.00 $0.00 Fire Plan Rev $0.00 $0.00 Demolition Fee $0.00 Building Dept Adm $26.00 General Service $219.00 Refund Deposit $564.00 Grading Bond: $0.00 $0.00 $0.00 Plan Check Fee: $8,974.48 Fee Due at Permit Issuance : $9,499.48 PROCESSED BY: !3 ••� - - PUBLIC WORKS APPROVAL: ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law forth a reasan(s) indicated below by the checkmark B) I have placed next to the applicable items) (Section 7031.51 Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cade) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). ❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason: By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legall) sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gcvlcalaw.htmi. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION l I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business and Profes;ions Co��jjj,,,eee, and my lic a is full fo,� and effect. License Class License No Da Contractor Signatur l/M b NORKERS' COMPENSATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL NALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for Wince of the work for which this permit is issued. Policy No. and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' caarrier and I licy number are: ,M lOy' Policy Number 71oc&2-1 Ff 72- /( Expiration Date ie of Agent certify that, in the performance of the work for which this if I should become subject ;a the /Igrprklots' com ensatt* lature of Applicant /" is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and jfns of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. hereby affirm under penalty Uf perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). -ender's Name Lender's Address 3y my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owner's behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and county ordinances and state I ws relating to building construction. I authorize representatives of this city or c nt to r e abovidentol5d property for in purposes. ,�11/I Signature of Property Owner or Authorized Agen Print Property Owner's or Authorized Agent's Name V 7 h ACTION DATE BY, ,�/TDECLARAJJORTOF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 15UBMTFED ASBESTOS NOT]FICATION TO I ' PERMIT CANCELLED LJEPA PERMIT EXTENDED QM PERMITFINAL lZ•/j_T ,tL r�,. LS BESTOS NOTIFICATIO 11 TAPPLICABLE TO CERTIFICATE OF PR POSED DEMOJdT10 �f /� / OCCUPANCYISSUED SIGNATURE: �( //_ ✓(�/L4.